Here is a detailed Neftaly Wellbeing Self-Assessment Template designed to help employees evaluate their current physical, mental, and emotional wellness. This self-assessment serves as a starting point for participation in Neftaly’s wellbeing and development initiatives, helping employees identify areas for improvement and track their progress over time.
Neftaly Wellbeing Self-Assessment Template
Issued by: Neftaly Development Strategic Partnerships Office
Under: Neftaly Development Royalty
Employee Name: ___________________________
Department: _____________________________
Date of Assessment: _______________________
Instructions:
This self-assessment is divided into five core areas of wellbeing. Rate yourself on a scale from 1 (Strongly Disagree) to 5 (Strongly Agree) for each statement. Be as honest as possible to get a clear picture of your current state of wellbeing.
Section 1: Physical Wellbeing
Focuses on your energy levels, physical activity, and overall health.
| Statement | Rating (1–5) |
|---|---|
| I get at least 7–8 hours of quality sleep most nights. | |
| I eat a balanced and nutritious diet regularly. | |
| I drink enough water and stay hydrated throughout the day. | |
| I engage in regular physical activity or exercise. | |
| I feel physically healthy and rarely experience chronic pain or fatigue. |
Subtotal (Physical Wellbeing): ______ / 25
Section 2: Emotional Wellbeing
Relates to how well you manage emotions, stress, and mental resilience.
| Statement | Rating (1–5) |
|---|---|
| I feel emotionally balanced and in control most days. | |
| I am able to manage stress in a healthy way. | |
| I feel positive and optimistic about my personal and professional life. | |
| I have healthy coping strategies for difficult situations. | |
| I rarely feel overwhelmed or emotionally exhausted. |
Subtotal (Emotional Wellbeing): ______ / 25
Section 3: Mental Wellbeing
Focuses on focus, mental clarity, learning, and intellectual stimulation.
| Statement | Rating (1–5) |
|---|---|
| I feel mentally focused and productive during my workday. | |
| I actively seek new knowledge or opportunities to learn. | |
| I manage my time effectively and can prioritize tasks well. | |
| I feel intellectually stimulated in my role. | |
| I take regular breaks to avoid burnout or mental fatigue. |
Subtotal (Mental Wellbeing): ______ / 25
Section 4: Social Wellbeing
Explores relationships, support systems, and work-life interactions.
| Statement | Rating (1–5) |
|---|---|
| I have strong, supportive relationships with friends or family. | |
| I feel connected to my colleagues and team at work. | |
| I make time for meaningful social interactions outside of work. | |
| I feel a sense of belonging in my work environment. | |
| I am comfortable seeking support when I need help. |
Subtotal (Social Wellbeing): ______ / 25
Section 5: Work-Life Integration
Evaluates balance, boundaries, and satisfaction with overall life roles.
| Statement | Rating (1–5) |
|---|---|
| I maintain a healthy balance between my work responsibilities and personal life. | |
| I set clear boundaries between work time and personal time. | |
| I have time for hobbies, rest, and activities I enjoy. | |
| I feel fulfilled both professionally and personally. | |
| I am able to disconnect from work when necessary. |
Subtotal (Work-Life Integration): ______ / 25
Overall Wellbeing Score
- Total Score (All Sections): ______ / 125
Reflection and Action Plan
- Which areas had the highest scores? What are you doing well?
- Which areas had the lowest scores? What might need attention or change?
- What are three small, achievable actions you can take this month to improve your wellbeing?
- How will you track your progress?
- Weekly check-ins
- Monthly reflections
- Journaling
- Using a wellness app
- Other: ______________________________________________
Next Steps
- Schedule a one-on-one discussion with a Neftaly Advice Desk Officer or Wellbeing Coordinator to review your results (optional).
- Incorporate your reflections into your Neftaly Quarterly Personal Development Plan.
- Reassess yourself at the end of the quarter to measure growth and improvement.